What is the purpose of psychotherapy?
We know well that psychotherapy is a therapeutic path for the resolution of psychological problems, emotional suffering and behavioral problems.
In a very generic way we can therefore say that its purpose is to solve these dysfunctional states, more or less persistent, and promote mental and emotional well -being and the best functioning of the person.
Generally when we talk about psychotherapy, attention and reflections are more often paid to the description of the symptoms, the analysis of the etiological hypotheses of the disorders that people can experience and to the models and interventions that prove effective in the resolution of the various problems.
What does it need why a psychotherapy is effective?
The first fundamental response we can give is that the psychotherapeutic model has shown itself effective to scientific experimentation.
Research in psychotherapy, today more than ever, does not only have the purpose of understand psychological disordersbut also to verify the effectiveness of the treatments through rigorous methodologies and which now more and more neuroscientific knowledge use.
And this is how, for example, cognitive – behavioral therapy has proven effective for numerous psychological disorders and today represents for many of these first choice psychotherapy.
But we must expand this reflection on the internal processes that psychotherapy puts in place.
First of all attention to the objectives
In the therapeutic models Evidence – Based such as cognitive – behavioral therapy and EMDR immediately, during the first evaluation phase that starts the therapeutic path, there is an explicit and shared attention to what are the objectives that the person arises or wants to achieve.
Not only do you ask ourselves what objectives and expectations are, but you also evaluate how realistic are and above all we try to define them in order to make the therapy itself assessed by patient and therapist along the way.
Most people who seek psychotherapy are interested in become a stronger or more effective person in the different areas of one’s life. And even those who have experienced important trauma often show themselves eager to “put themselves at work” and solve quickly.
And in this process a transversal objective typical of these approaches is immediately put at the center of the therapeutic space which is a constructive and participatory collaboration of both actors of psychotherapy: patient and therapist.
Above all, the most complex situations lead us to make further considerations.
What does psychotherapy leverage?
Dating the pain of trauma can be very painful and harmful if done without adequate preparation, as well as changing emotional-cognitive and behavioral patterns can be initially extremely difficult.
A central and transversal objective and at the same time that on which psychotherapy leverages is the part of the person who can understand himself and give adequate response to their needs.
Gradually disturbing trauma and negligence seriously disturb the way people perceive themselves and how they take care of themselves.
Those who grew up in neglected or abusive contexts have not learned to take care of themselves Because those who should have done do it mistreated or failed to provide adequate care.
Unfortunately, many people learn that having needs is bad or that is not allowed, and someone even learns to punish themselves instead of taking care of themselves (Gonzalez and Mosqura, 2015).
Children internalize early experiences with caregivers and see themselves in the same way they are seen by the important adults of their life.
A job on one’s care skills then becomes sometimes essential to prepare the patient and to take an active, positive and constructive attitude within the therapeutic process.
Since Freud’s time, the “strengthening of the ego” has been considered a fundamental component of the therapeutic process and so today it is expected in many therapeutic approaches.
In fact, psychotherapy requires an initial stabilization phase, safety and strengthening, as a fundamental basis for any subsequent intervention.
So, for example, in the EMDR, the introduction of the development and installation of resources was reached in the preparation phase. But also throughout the path and in the Therapy scheme, the healthy adult mode has been conceptualized.
The healthy adult of the Therapy scheme
The Therapy scheme was developed by Young (2003) for those patients who did not respond well to “classic” behavioral cognitive treatment and integrates it with greater focus on:
- problematic emotions (making intensive use of experiential interventions and focused on emotions)
- The themes and biographical information that allow the person to understand the origins of his problems
- The therapeutic relationship, where the therapist becomes a model of a warm and loving and loving therapeutic relationship (within the limits of the therapeutic relationship, which allows the expression of needs and pain and the experimentation of new ways.
The healthy adult is the part of us who is realistic, that is, able to accept himself and take care of himself.
It is based on the ability to empathize to bring respect to oneself and others, gradually recognizing their defects and errors.
The healthy adult is the part of us who knows how to recognize and validate our needs, based on the recognition of one’s sensations, recognizing the right to satisfy them and seek what is needed for this purpose.
Those who have suffered from neglect or children who grow with their physical and emotional needs ignored or suffocated by shame, lack the ability to clearly discriminate both the sensations and the needs, and consequently to respond adequately.
The healthy adult is also that part capable of recognizing the needs of others.
In fact, adult decision -making capacity is not guided by the immediate satisfaction of one’s needs as happens in a child, but by the introspective and reflective ability that guides one’s well -being within a social framework of reciprocity, fundamental for a satisfactory life.
The healthy adult is also the part that knows how to protect itself adequately, placing boundaries and learning to “say no” in a respectful way to others (Gonzales and Mosqura, 2015).
In conclusion, it is the part of us who knows how to see us “with the best possible eyes” and who knows how to deal with loyalty and affection with that accepting way that is part of the proposal of the acceptance and Commitment Therapy (Act, Hayes et al. 1999). And the non -judgmental vision of the Mindfulness approach that is the behavioral cognitive approach that the EMDR have integrated into their paths.
Like the Therapy scheme strengthens the healthy adult
One of the central objectives of the Therapy scheme is to strengthen the healthy adult.
This is partially obtained indirectly, reducing the emotional, cognitive and dysfunctional behavioral patterns.
For example, when the person learns to contain the influence of an internalized punitive parent, the self -director’s punitive behaviors are also decreased.
But this does not always necessarily lead to learning new and healthy things. Therefore, when the healthy adult is a very little developed part in the person it is not enough to “take away” the sick parts, the therapy also focuses directly on the learning of healthy attitudes and behaviors (Arntz et al. 2013).
The therapeutic relationship
The therapist always tries to relate to the healthy adult of the patient, with the common goal of a constructive collaboration And the joint assumption of liability.
The therapeutic model is explained and the adult is asked to reflect on the therapeutic process, to express in a healthy way emotions and needs and also to face the problems and blocks together in the therapeutic process, finding joint solutions.
Cognitive techniques
Sharing between therapist and patient of the Therapy scheme model It represents an important cognitive work that requires continuous reflections on its operating patterns and joint reflections about the interventions to achieve the objectives.
Also the technique of Socratic questions It accompanies patients to a more equitable and adult reflective perspective than themselves and the world.
Emotional techniques
The interventions focused on emotions that strengthen the healthy adult are mainly dialogues with chairs (therapeutic methods taken from the Gestalt approach) ee the exercises of Imagery Rescripting.
Dialogue with the chairs allows the patient to distinguish the different parts of the patient. Each part sits on a chair and takes that perspective there, he feels those emotions and expresses himself.
Thus it gives the opportunity to clarify the internal conflicts, the ambivalences, validate the needs, the intentions and reflect on the pros and cons of each part.
In the images of Imagery Rescripting, an emotionally stressful situation is accessed through the mental imagination and through the flexibility and creativity of the therapist and gradually more and more than the healthy adult, the image and events are changed in the imagination in order to give in the exercise adequate response to the needs of the person and develop the possibility of healthy and positive emotional experiences.
Behavioral techniques
The prospects and behaviors of the healthy adult are gradually transferred from the setting of therapy to the daily life and the social world of the person. The possibility of the person to engage in healthy and satisfactory activities is therefore enhanced, with a good balance between obligations and fun; The ability to engage in study and work.
The healthy adult as an agent and goal of therapy
If at the beginning of the therapy, healthy adult is very weak, it is modeled and strengthened directly by the therapist or other help figures.
Then the part of the patient will be more and more to act in the patient’s therapy and context of life.
Psychotherapy is a journey, sometimes very demanding, which requires evaluations and preparation.
Unexpected or demanding events may occur and we must therefore be equipped for the adventure.
It is important to immediately understand the resources we have available, how we will organize them effectively, what further preparation requires and how we will divide the responsibilities of this company.
Where the point of arrival is the integration of oneself in a new identity.
Bibliography
- Arnerz et al. 2013. Therapy scheme in action: theory and practice. Establishing of Cognitive Editore Sciences, Sassari
- Forgash et al. 2014. Emdr and Ego State Therapy. The treatment of trauma and dissociation. Ferrarisinibaldi Edizioni, Milan
- Hayes Sc et al. 1999. Acceptance and Commitment Therapy: an expertiential approach to behavior change. Guilford Press, New York
- Gonzales A. and Mosquera D. 2015. EMDR and dissociation: the progressive approach. Giovanni Fioriti ed., Rome
- Young Je et in 2007. Therapy scheme. Cognitive-behavioral therapy integrated for personality disorders. Eclipsi, Florence.
